Pro Rehab Director

The steps employers should take at the first complaints of a work-related psychological injury are quite simple, but too often overlooked, according to specialists.

Employers will often have questions about the validity of such an injury or claim, but nevertheless must treat employees consistently, and in each case provide a “sensible and unemotional response”, Pro Rehab Solutions director Nicole Dowsett told a recent Kemp Strang briefing.

Taking the right steps will “really quickly sort out the ones that are genuinely unwell, and the ones that are over-exaggerating symptoms, whether it’s for personal or secondary gain”, she says.

Some of the more common causes of work-related psychological injuries are performance investigations, conflict with colleagues, high workload, demotions, terminations and grievance management, and don’t meet the criteria for compensation, Dowsett says.

But it’s crucial for employers to manage these situations well from the outset, she said. “A lot of the time… claims are being accepted and because of the poor management of something that really shouldn’t have been accepted in the first place.”

Generally, managers should be better equipped to recognise the signs and symptoms of mental health problems, Dowsett says.

For example, managers should be aware that workers aged in their forties are at greatest risk of experiencing distress as a result of burnout and vocational discontent, research shows.

Studies also show certain personality styles are more often associated with psychological injury claims. At particular risk are individuals who: have a highly personalised, sensitive reaction to ordinary workplace events (high levels of emotionality); possess perfectionist traits; exhibit paranoid and distrustful thinking; and have high levels of self-focus or sense of entitlement.

The red flags managers should look out for include absenteeism, a decline in productivity, withdrawal from co-workers or managers, erratic or unusual behaviour, tardiness, decline in hygiene or personal care, becoming easily tearful or irritable, and displaying a noticeable increase in bad habits such as smoking and drinking, Dowsett adds.

Dowsett says when employees do notify employers of a psychological injury it is appropriate to:

• phone or meet with the worker and offer assistance;
• keep the communication channels open and confirm the worker’s preferred mode of contact and timeframe – for example weekly or fortnightly;
• offer to visit the doctor with them;
• offer an employee assistance program;
• request an injury management consultation early to liaise with the employer and the treatment providers – importantly, they should not just rely on the employee’s GP’s advice;
• discuss work task demands, to prevent stress exacerbating the condition;
• discuss support mechanisms at home;
• discuss the workplace and what employees are comfortable with co-workers knowing about their absence or work restrictions; and
• request an independent medical examination if there are questions around causation and liability.

These points are pretty straightforward, Dowsett says, but in many cases by the time she sees employees “these little steps haven’t been followed and it makes such an impact”.

Too many employers wait too long to provide assistance, when early intervention is best, she adds.

“The mode of getting better first, and then returning to work is demonstrably unsuccessful and really unhealthy. There was all this notion that you have to be better to get back to work and in actual fact, that’s not the case. Work needs to be a part of someone’s recovery.

“We see clients that have been out of work for 10 years and it’s so hard to then pick up the pieces at the later stage, where if you start early, it’s a much easier process.”

Practical tips

Also speaking at the briefing, Kemp Strang senior associate Ben Urry and Pro Rehab Solutions clinical psychologist Helen Austen used case studies to illustrate risk minimisation and practical steps, respectively, that employers should apply in common scenarios involving workers with psychological conditions.

Pre-existing conditions

In the first example, a worker performed her job without incident for a year before her behaviour became erratic, with frequent outburst towards co-workers and employees. When questioned by her employer, she said she had stopped taking her medication for her pre-existing diagnosis of bipolar disorder.

When faced with this scenario, Urry says it’s important to remember that employees are not obliged to tell employers they suffer from a pre-exisiting condition if it does not impact their work.

Any consideration about whether to dismiss the employee should take into account that terminating in these circumstances could result in an unfair dismissal claim, general protections claim or disability discrimination claim, he adds.

He advises employers to review their policies about disclosing medical conditions, and adds that the key to reducing some of the legal risks is the quality of engagement with the employee. Even if it’s “doing something little”, the employee is less likely to take an aggressive stance and that might ultimately affect the extent of legal action.

On the practical side, Austen recommends that employers should:

• keep communication channels open;
• deal with the situation sensitively, and understand as much about the condition as possible;
• offer to attend GP appointments;
• explore alternative work arrangements such as work from home or different work hours; and
• involve an independent examiner if the employee is not responding to communication efforts.

Unexplained medical conditions

The second hypothetical involved a worker whose performance dropped noticeably, and who failed to attend a scheduled performance meeting. He submitted a medical certificate requiring an absence of four weeks due to a “medical condition” associated with “workplace bullying”, and four weeks later produced another certificate for extended leave.

In this type of situation, Urry advises employers they have a right to more information, and should request it as early as possible, as well as seek authority to speak to the worker’s GP.

They should also start the bullying investigation process (even if they have doubts about the employee’s claims) and seek more information from him about his allegations. The worker should also be put on notice that when he returns, his performance management process will resume.

Austen also advises employers to act early rather than wait until the end of the certified period to inquire about or challenge the worker’s condition.

Further, if the employee isn’t answering calls, the employer should appoint an independent provider who can facilitate communication and feed back information to all parties.
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